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Schizophrenia 1 month of at least two of the following: delusions hallucinations disorganized speech disorganized behavior negative symptoms positive/psychosis.

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Presentation on theme: "Schizophrenia 1 month of at least two of the following: delusions hallucinations disorganized speech disorganized behavior negative symptoms positive/psychosis."— Presentation transcript:

1 schizophrenia 1 month of at least two of the following: delusions hallucinations disorganized speech disorganized behavior negative symptoms positive/psychosis disorganized negative

2 delusions What types of schizophrenic delusions have you heard of? persecution grandeur control reference

3 hallucinations What kinds of schizophrenic hallucinations have you heard of?

4 disorganized speech tangentiality derailment neologisms clanging A.K.A. THOUGHT DISORDER

5 disorganization DISORGANIZED BEHAVIOR inappropriate affect bizarre behavior

6 negative symptoms alogia (few words) affective flattening avolition (lack of motivation) social withdrawal

7 age of onset stats 1% prevalence equal sex ratio course: better for women

8 medication ANTIPSYCHOTICS (A.K.A. neuroleptics) treats + symptoms side effect: tardive dyskinesia TYPICALATYPICAL treats + & - symptoms? less side effects? 10x price 74% noncompliance w/in 18 mo

9 major depressive episode depressed mood or loss of interest/pleasure appetite or body weight change (5%+) sleep problems psychomotor agitation or retardation fatigue feelings of worthlessness or guilt poor concentration thoughts of death or suicide (distress or impairment) For 2 weeks, 5+:

10 manic episode inflated self-esteem/grandiosity less need for sleep excessively talkative racing thoughts too easily distracted increased goal-directed activity/ psychomotor agitation excessive pleasurable but risky activities 1 week of elevated, expansive, or irritable mood and 3+:

11 mixed manic episode Meets criteria for both major depressive episode & manic episode. hypomanic episode Less severe than mania & does not cause impairment (at least 4 days)

12 unipolar mood disorder Major Depressive Disorder, single episode (rare!) Major Depressive Disorder, recurrent

13 bipolar I disorder a manic episode bipolar II disorder hypomanic episode + major depressive episode the following are all chronic w/ poor prognosis

14 antidepressant meds TRICYCLICS – monoamine reuptake inhibitor MAO-Is – inhibits the enzyme that breaks down monoamines (tyramine & the cheese effect) SSRIs – selective serotonin reuptake inhibitor

15 mood stabilizers LITHIUM (therapeutic vs. lethal dosage window) -kidney dysfunction & seizures ANTICONVULSANTS (valproate, carbamazepine) - Less effective than lithium for suicide

16 ECT 65-140 volts for half second produces seizure for 30 secs to few minutes. Applied 3x/week for 4 weeks.

17 generalized anxiety disorder 6 mo+ of uncontrollable worry to many issues 3+ of: restlessness, fatigue, poor concentration, irritable, muscle tension, sleep probs distress or impairment CRITERIA

18 benzodiazepines Valium Librium Xanax Also used for sleeping pills & anti-seizure meds

19 panic attack inappropriate fear response CRITERIA 4+ of: heart palpitations, sweating, shaking, short of breath, choking, chest pain, nausea, dizzy, derealization/depersonalizaiton, fear of losing control, fear of dying, chills/heat, numbness/tingling

20 panic attack cued – conditioned to external cues uncued – conditioned to interoceptive cues situationally predisposed

21 panic disorder CRITERIA recurrent panic attacks 1+ for 1 mo+: - concern about future attacks or consequences - sig behavioral change (avoidance of external or internal cues)

22 panic disorder prevalence 3% 2:1 sex ratio onset teens-40 yrs rels 8x more likely concordant TREATMENT medications cued: systematic desensitization uncued: induce interoceptive sensations + cognitive restructuring of perceived control

23 agoraphobia CRITERIA anxiety about situations where: - hard to access help - escape difficult/embarrassing

24 specific phobia CRITERIA 6+ mo persistent, excessive, irrational fear of an object of situation anxiety/fear on exposure avoided or endured w/ intense anxiety insight that phobia is irrational

25 specific phobia 9% prevalence 4:1 sex ratio prognosis: chronic CAUSE direct or vicarious trauma exp or conditioning from panic attack, information transmission TREATMENT systematic desensitization

26 social phobia CRITERIA fear of social/performance situations anxiety/fear upon exposure insight that fear is irrational avoidance behavior impairs functioning

27 social phobia 7% prevalence 1: 1 sex ratio onset: adolescence CAUSE prepared learning of social disapproval or, neuroticism/inhibition, conditioned direct exp TREATMENT MAO-Is, systematic desensitization, cognitive therapy

28 OCD CRITERIA recurrent & persistent thoughts/images associated behaviors compelled to perform insight to irrational “ distress, consumes 1+ hr/day, or impairs functioning

29 ocd obsessions repetitive, unwelcome thoughts compulsions repetitive, almost irresistible action germs something bad will happen symmetry religion #s washing counting checking touching rituals

30 OCD 1% prevalence sex ratio? onset: childhood-30’s (earlier in males) prognosis: chronic thought-action fusion (belief that thought is equivalent of the behavior) TREATMENTS SSRIs, exposure & response prevention


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